Provider Reimbursement Manual, Part 1 - Chapter 27, Sections 2721, 2722 and 2725, Request for Exception to End Stage Renal Disease Composite Rates and Supporting Regulations in 42 CFR..

Provider Reimbursement Manual, Part 1 - Chapter 27, Sections 2721, 2722 and 2725, Request for Exception to End Stage Renal Disease Composite Rates and Supporting Regulations in 42 CFR..

OMB: 0938-0296

IC ID: 7947

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Provider Reimbursement Manual, Part 1 - Chapter 27, Sections 2721, 2722 and 2725, Request for Exception to End Stage Renal Disease Composite Rates and Supporting Regulations in 42 CFR..
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-9044 No No


    

125 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 125 0 -166 0 0 291
Annual IC Time Burden (Hours) 6,000 0 -8,000 0 0 14,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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